breastfeeding and HIV

[lboogie]

how safe is it for a HIV positive woman to breastfeed and for how long should she do it?
what are the safest feedind options for an HIV positive mother?

[NazirsMom]

I don't know....maybe ask an LLC or an HIV specialist

[NewMum]

http://www.avert.org/motherchild.htm

http://www.jhsph.edu/publichealthnews/Press_Releases/2005/Humphrey_breastfeeding.html

http://www.unicef.org/programme/breastfeeding/hiv.htm

There are many more... just google breastfeeding hiv

According to almost all the sites, the best way for an HIV + mother to feed her child is with formula, but only if it's "acceptable, feasible, affordable, sustainable and safe."

If one does choose to breastfeed, it should be exclusive- no formula, water, solids etc, b/c it lowers the risk of transmission. Mixed feeding increases the risk significantly

As for duration, shortest time is best. After 6 months the risk of transmission drastically increases.

How safe?? The risk of transmission is estimated to be between 15 to 25% in the US and other industrialized countries.

[KerryS]

In the US and other developed nations, breastfeeding is not recommended. Instead, a woman should feed her baby donor breastmilk or formula. In developing nations that don't have ready access to clean water supplies, it's recommended that a woman EXCLUSIVELY breastfeed, and as soon as the baby eats anything other than breastmilk, she needs to cold-turkey wean.

[KerryS]

As for duration, shortest time is best. After 6 months the risk of transmission drastically increases.

Only because around 6 months is when supplementary foods are usually introduced. As long as the woman continues to EXCLUSIVELY breastfeed, the baby should still be protected.

[NewMum]

Only because around 6 months is when supplementary foods are usually introduced. As long as the woman continues to EXCLUSIVELY breastfeed, the baby should still be protected.

I agree... somewhat.
I am sure transmission is usually due to a lack of exclusivity.

But, the longer you breastfeed, the greater chance that some complication will arise, be it cracked nipples, mastitis, sores in baby's mouth or thrush, which all increase the risk of transmission.

and as soon as the baby eats anything other than breastmilk, she needs to cold-turkey wean.

Because rapid weaning (taking just a few days to move from breast milk to other foods) minimises the period of mixed feeding, it may reduce the risk of HIV transmission. However some studies suggest that rapid weaning may increase the likelihood of severe diarrhoea among infants, and the effect on transmission rates is uncertain.


An HIV-positive mother can improve the safety of her own breast milk by expressing it into a container and submitting it to either flash-heating or Pretoria pasteurisation. Flash-heating is achieved by placing the covered container in a pot of water and heating until the water bubbles, then removing the container and letting it cool. Pretoria pasteurisation involves boiling a small pot of water, removing it from the heat, immersing the container, covering the pan and leaving it to cool for 20 minutes. Both of these methods, if performed correctly, destroy HIV while preserving much of the goodness of the milk.

Personally, I couldn't take the risk. But if I had to, the above would be my choice.

I hope anyone dealing with this situation would take advantage of counseling and support. I know it must be extremely hard to weigh the risks/benefits to do what is best for the baby and the mother.

[ima062002]

If a mom has access to clean water then it's recommended to formula feed (if donor milk is out of the question) because the virus does pass with breast milk.

This link had a list of links that cover the subject - http://www.kellymom.com/health/illness/mom-illness.html#HIV.

But - HIV-positive women might want to consider expressing and treating their milk to deactivate its HIV content before feeding it to the infant. Sadly, the UN Guidelines were also issued before research had been done to develop and test simple methods for doing so, such as heating up the milk to a certain temperature or freezing it. Milk banks utilize Holder sterilization which involves maintaining the breast milk at 62.5 degrees for a half hour. Boiling will also deactivate the HIV, and though it will also destroy some components in the breast milk, boiled human milk remains more physiologically suited to the human infant than a formula prepared from animal milk.
Source: http://www.llli.org//ba/May00.html

[KerryS]

Personally, I couldn't take the risk. But if I had to, the above would be my choice.

In the US, you don't have to (nor should you). Formula use is not the death knell here the way it is in areas of Africa, for example.

[NewMum]

In the US, you don't have to (nor should you). Formula use is not the death knell here the way it is in areas of Africa, for example.


Oh, I know. That's what I meant. I would give formula if I were in this situation.

If I was somewhere else and circumstances were different, I would take precautions for safer breast milk.